Most doctors are well respected, even beloved, by the vast majority of patients. In the broad spectrum of patient-provider relationships, physicians have a positive head start. As the widely held and generally correct stereotype goes, skilled and experienced professionals in the healing arts are intelligent, well educated who do good for patients and the community at large.

Until quite recently, the job title of doctor was regarded as an unassailable leader and unquestioned first chair in the health care delivery team. (Until recently.) The many changes in the industry and the attitudes and perceptions among patient demographic groups have, in some ways, disconnected this previously unassailable hierarchy.

The Millennial cohort is now the driving force…

The ever-steady and predictable population bunch—commonly known as Baby Boomers—have given the top demographic spot to Millennials. This crowd is now the largest audience group, controls the most spending, and is in a hurry about everything. What’s more, dissatisfied Millennials will quickly and easily change their connection to another healthcare provider.

For this crowd, it’s mostly a matter of convenience, affordability and accessibility. (And has less to do with a doctor’s professional reputation or community standing.) Their expectations are often time-driven, wanting answers and service without delay. (And certainly without waiting in this digital age.)

What’s most curious about this reinvention of the doctor-patient relationship is that most doctors have, and continue to earn, a five-star review from most patients. In general, negative comments tend to be fewer, with only a few about the course of treatment or medical care.

Why most patients quietly disappear…

Unlike Boomers before them, Millennials are not closely bonded to a hospital, a practice or a provider. They easily shift to a new or different healthcare resource…mainly because of service issues, and not because of clinical care. Historically, the main reason that a patient would change providers was due to an attitude of indifference. There was no drama in “firing their doctor,” they simply went elsewhere.

Surveys among patients point mainly to complaints about patient satisfaction. Generally, patients found fault with communications, long wait times, practice staff professionalism, and to a lesser degree, issues of billing.

The main gripes among patients—and the things that are most likely to create a negative online review and/or changing to another provider or office include:

Waiting for an appointment, then waiting again. Millennials in particular, who have always known instant answers from their ever-present Internet, simply do not like to wait. A typical experience of waiting two or more weeks to get an appointment (plus having to wait in the office to be seen) is often intolerable.

Issues with the office staff. Any given patient is bound to spend far more time with staff members than with the physician/provider. Their expectation of professionalism, respect and a warm relationship is a common area of disappointment and frequent complaint. It may be perceived, real or imagined, but the office staff is one of the main issue topics.

Disrespect for patients’ time. The doctors who demonstrate (unintentionally or otherwise) that their time is more valuable than their customers may be on a short fuse. Patients who are first made to wait and then feel that service is rushed, are likely to change providers. It’s no longer permissible to waste a patient’s valuable time.

Not finding a “retail experience.” Curiously, in the retail world, today’s typical customer expects—even demands—a high level of respect, service and assistance. By comparison, the typical, old-school service in healthcare is nearly the opposite of retail, online buying or most other service industries.

Service is the primary reason that patients leave. Increasingly, consumers and empowered buyers fire their provider and take their business to a competitor. The positive and desirable customer experience of the retail world continues to have a dramatic influence on healthcare delivery in the US.

Stewart Gandolf, MBA, is CEO of Healthcare Success, a medical marketing and health care advertising agency. He is also a frequent writer and speaker. Most importantly, he is happily married and a "rock-n-roll daddy" to two wonderful girls.

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